Over 200,000 prescriptions were wrongly claimed using the HRT Prescription Prepayment Certificate (HRT PPC) between June 2024 and May 2025, according to data from the NHS Business Services Authority (NHSBSA).

The data, shared by Community Pharmacy England (CPE), suggested that sertraline was the most common medicine for which patients were incorrectly claiming a prescription charge exemption using the HRT PPC.

The cause of the issue is likely a combination of patients not knowing which HRT medicines are eligible, and pharmacy teams not alerting patients if they have selected the HRT PPC exemption for products which are not eligible, according to CPE.

Other examples of products which are not on the approved list of medicines covered by the HRT PPC include:

  • Amitriptyline 10mg tablets
  • Amlodipine 5mg tablets
  • Amoxicillin 500mg capsules
  • Atorvastatin 20mg tablets
  • Citalopram 10mg tablets
  • Citalopram 20mg tablets
  • Fluoxetine 20mg capsules
  • Lansoprazole 30mg gastro-resistant capsules
  • Medroxyprogesterone 10mg tablets (Provera)
  • Methadone 1mg/ml oral solution sugar free (Physeptone)
  • Naproxen 500mg tablets
  • Nitrofurantoin 100mg modified-release capsules
  • Omeprazole 20mg gastro-resistant capsules
  • Ramipril 2.5mg capsules
  • Sertraline 100mg tablets
  • Sertraline 50mg tablets
  • Sumatriptan 50mg tablets
  • Testosterone 40.5mg/2.5g transdermal gel unit dose sachets (Testogel)

A list of HRT medicines which are covered by the HRT PPC can be found in Part XVI of the Drug Tariff. Patients can also consult the NHSBSA website for an up-to-date list of the medicines that are covered.

CPE reminded pharmacy owners that any time a patient makes a declaration that they are exempt from paying an NHS prescription charge, pharmacy staff must ask them to sign a declaration and produce evidence.

It is the patient’s responsibility to check that they have the correct exemption in place when claiming a free NHS prescription and they are advised to use NHSBSA’s eligibility checker to do so.

The NHSBSA will continue to process prescriptions in accordance with the exemption or charge status declared by the patient. However, if NHSBSA’s Exemption Checking Services (ECS) cannot confirm that a patient was entitled to claim free NHS prescriptions, the patient will be sent an enquiry letter asking them to confirm their entitlement.

And CPE said the government had advised that patients found to have wrongly claimed help from the NHS with the cost of their NHS prescriptions will face a penalty charge and, in some cases, prosecution.

The HRT PPC scheme was launched on 1 April 2023 and in November 2024, NICE emphasised the importance of HRT as a ‘first line treatment’ for menopause symptoms.